Are concentrations higher than 5% minoxidil of benefit for androgenic alopecia patients?
A literature review published in Clinical and Experimental Dermatology assessed the available evidence regarding the use of topical minoxidil at concentrations higher than 5% for the treatment of androgenic alopecia.
Several studies suggest that a 15% minoxidil formulation is superior to a 5% formulation; however, one study reports the superiority of 5% compared with that of a 10% formulation. Another report suggests that at concentrations greater than 7.5%, minoxidil is insoluble and is therefore not likely to provide additional benefit. The added benefit of using formulations higher than 5% remains unclear.
Finasteride: Topical vs. oral for male androgenetic alopecia. Read more in DermWorld Weekly.
DermWorld Insights and Inquiries: BASCULE syndrome: Is something brewing with Bier spots?
I have never paid too much attention to Bier spots, other than reassuring patients that they are of no concern. I may have been too cavalier by not probing further. Classical Bier spots were first described by the German surgeon Augustus Bier in 1898. BS are multiple, asymptomatic, pale, and irregularly shaped “anemic” macules appearing on a cyanotic background. In 2016, Bessis et al described four cases of a possible “new” entity, which they named BASCULE syndrome (Bier Anemic Spots, Cyanosis with Urticaria-Like Eruption).
The index case, similar to many subsequent reports, follows: “A 14-year-old girl with no relevant medical history was admitted for the evaluation of disseminated pruritic cutaneous lesions, which had appeared two years previously and were progressively worsening. The lesions developed after one to two minutes in a standing and immobile position, were associated with disabling pruritus and were relieved by sitting, walking around, or raising the limbs.” Keep reading!
Emollient creams exhibit diverse effects on skin barriers of AD patients
A study published in Clinical and Experimental Dermatology examined various emollient creams to see how they impacted the skin barrier in adults with atopic dermatitis (AD). In a prospective, phase 2 randomized controlled trial, an emollient with urea and glycerol was compared to a no-treatment control, a glycerol cream, and a paraffin cream with no humectant. The intervention involved four weeks of treatment, twice daily, with the three products applied to the forearms.
The urea-glycerol cream was found to be more effective in reducing transepidermal water loss, improving skin moisturization, and providing protection against skin irritation. The paraffin cream had no effect on the skin’s barrier and reduced the natural moisturizing factor. The glycerol cream performed better than the paraffin, but not as well as the urea-glycerol cream. The results showed that not all emollients provide equal benefit against AD and that only certain emollients improve the skin’s barrier and protect against irritants that may trigger AD.
Complications with fat and cellulite reduction devices
In a study published in Dermatologic Surgery, researchers used the Manufacturer and User Facility Device Experience (MAUDE) database to evaluate the complications associated with the use of noninvasive fat reduction and cellulite reduction devices from Jan. 1, 2014, to Jan. 1, 2020.
They identified a total of 165 medical device reports (MDRs) — most of which were submitted by patients. Cryolipolysis had the most MDRs (41.2%), including paradoxical adipose hyperplasia, hernia, burns/scarring, neuropathy, and tissue necrosis. Other MDRs included 1060-nm laser lipolysis (20.6%), high-intensity focused ultrasound (11.5%), vacuum-assisted subcision (10.3%), 1440-nm laser-assisted subcision (6.1%), monopolar radiofrequency (4.8%), and focused ultrasound (3.6%).
In its comment letter to CMS on the proposed 2023 Medicare Fee Schedule, the AADA called on CMS to use any available regulatory authority to mitigate the impact of a 4.5% cut to the conversion factor, and work with Congress to develop long-term solutions, including adding an inflationary update to the physician fee schedule. Stabilizing Medicare payment for physicians is one of AADA’s top advocacy priorities and will be a key focus during AADA’s upcoming Legislative Conference.
The AADA also provided robust comments in response to a CMS request for information on global surgical package valuation, calling out its misguided focus on the valuation of these services and questioned the methodology of previous studies conducted by the RAND Corporation that CMS continues to rely on to substantiate their concerns. The AADA urged CMS to work through the regular AMA RUC process to ensure an adequate and fair review of these services.
Additionally, the AADA:
Shared its support for a CMS proposal to extend certain Medicare telehealth flexibilities for an additional 151 days after the end of the COVID-19 Public Health Emergency.
Expressed support for a CMS proposal to delay implementation of new rules for reporting split (or shared) E/M visits.
Urged CMS to maintain MIPS Measure 265: Biopsy Follow-up for reporting in the traditional MIPS program and for future MIPS Value Pathways.
Called on CMS to work with specialty societies as the agency moves forward with plans to develop more MVPs in order to minimize additional burdens on physician practices.
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